How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $602.56 Median $3,388.44 Typical High $9,120.11 | Facility | None | $602.56 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $537.03 | Professional | None | $316.23 | $457.09 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $758.58 | Professional | None | $363.08 | $512.86 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,187.76 | Facility | None | $588.84 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $776.25 | Professional | None | $346.74 | $478.63 | $776.25 |
Denver HMP Setting Facility Modifier None Typical Low $316.23 Median $457.09 Typical High $691.83 | Facility | None | $316.23 | $457.09 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $794.33 | Professional | None | $363.08 | $524.81 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $1,230.27 | Facility | None | $478.63 | $870.96 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $478.63 | Professional | None | $316.23 | $389.05 | $478.63 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $891.25 | Professional | None | $338.84 | $512.86 | $891.25 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $158.49 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $93.33 | Professional | 53 · Discontinued | $63.10 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $239.88 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $323.59 |
Where Colorado sits
The same service costs 4.9 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 23rd of 51
$525
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.